Hello everyone! I
am Mohd. Javed Ali from Hyderabad, India. I
passed my FRCS at the first attempt! Believe me
I had prepared only for a month because of my
oculoplasty fellowship that ended a month before
FRCS. My great friend Maaz Mohiuddin (an
excellent phaco and corneal surgeon!), who also
appeared for it for the first time and passed,
was a great support during the exams! My
experience is as follows:

DAY 1:

Essays:
Always remember to get all the past and model
essays from Dr Muthu! (www.mvupgo.com
) . Thankyou Dr Muthu, You were of great help as
a teacher and a great friend!!

I was exempted
from MCQ’s part!

DAY 2:

Always keep
smiling during all these stations. Appear
confident, walk confidently towards your
station, shake hands with the examiners and
introduce yourself. Wait for them to ask you to
sit down! Say thank you when they do so! Be in
apt attention when they ask you questions. Every
word they speak has a meaning! Never bluff if
you don’t know the answer! Say you cannot
recollect or you do not know, so that the
examiner shifts to another question. Never start
digging without knowing where to dig!!

Dr Ayman’s FRCS
group and their files are very important for
both viva and clinicals. THANKYOU DR AYMAN FOR
THOSE GREAT PRESENTATIONS AND ALL THE HELP YOU
GIVE TO ASPIRING CANDIDATES!!

Ophthalmic Medicine:

I think it is
immaterial to know who the examiners were and
what was their race!

The examiner began
with giving me a paper that had a dendritic
pattern with 52 written beside it! Asked if this
is the clinical picture and 52 is the pressure,
Give me the prescription. I gave the
prescription and supported with HEDS studies!

Examiner that
showed a photo of Fuch’s uveitis without
heterochromia! Asked for the management. Than
asked how would you manage the other eye if
pressure is 24 mm. I replied that the other eye
has nothing to do with fuch’s! the examiner
smiled and than asked me whether I would treat a
pressure of 24 mm of Hg in an otherwise normal
patient! I asked him what is the CCT, he said it
is 470nm, I than asked him how did he measure
the IOP! He said goldman’s. I told him that I
would look for fundus for peripapillary changes
and RNFL defects as well as C:D ratio before
deciding! The discussion than went on to OHTS
study!

The other examiner
than showed photos of graves ophthalmopathy!
(Seeing Orbits and Oculoplasty cases gave me so
much relief in this examination. Anybody would
be happy if they get their respective
subspeciality cases!)

Discussion went
into details of management of compressive optic
neuropathy. (All managements should start with
history, clinical approach, investigations and
treatment. Never Jump onto treatment from the
beginning!)

Told the examiner
about the management, involvement of the
internists, medical management and at the same
time preparing the patient for investigations as
they may require surgical intervention.

The examiner than
showed me the photograph of Cherry red spot and
the discussion went into DD and management of
CRAO.

At the end of it
both the examiners appeared happy and pleased!
This was my best station!

General Medicine and
Neurophthalmology

The general
medicine examiner was very interested in
pulmonary emergencies! ( I believed I did
general medicine better than neurophthal! My
fellowship in emergency medicine came very handy
in this part! Nonetheless always study Oxford
handbook of emergencies! Never speak anything
that you have not done or not sure in
emergencies. Always involve your internists in
the answer as much as possible to be on the safe
side!)

The examiner than
showed a picture of a tongue with deep furrows
and grayish patches! Could diagnose it as thrush
only after examiner gave a clue!

Discussion went
towards IVDA’s (intravenous drug abusers) and
AIDS. Lastly he asked me does HIV spread through
mosquitoes? I replied there is speculation like
these but have not yet been proved convincingly!

The neuro-ophthalmology
examiner discussed a lot about anisocoria ,
horner’s, adie’s, ARP’s, 3N palsy and was not
appearing happy with some of my answers. As I
was sinking , the best part began as he started
discussing the use of drugs by other specialists
like cardiologists, pulmonologists,
dermatologist, rheumatologists and their ocular
significance. I love pharmacology and did this
part really well to neutralize examiner’s
initial negative mood.

Ophthalmic Surgery and
Pathology.

Never comment upon
surgeries that you have not seen or not done!
Rehearse the pathology slides from Kanski well!

I did not do the
ophthalmic surgery part well! The examiner was
really getting irritated!

The examiner began
by asking me squint surgeries, giving clinical
scenarios of Eso and Exo and asking how much
recession/resection you would do in each eye! I
just knew what kanski had given for squint and
not these! I told the examiners frankly that I
do not know much of squint and have not seen
them very often! I thought he would change the
topic and guess what! To my surprise he began
asking difficult squint surgeries like how would
you do IO transposition! I could not answer much
and I knew I am failing, just when god came to
the rescue and the examiner probably wanted to
make my life difficult by asking Wiess and
Quickert’s procedures for lid malpositions!

I told myself
quietly: Wow! He does not know that he is in my
house now! I discussed them well to his
satisfaction and it was so nice to see the frown
on his face becoming more and more aesthetic!

The pathology part
went well! (There was a dual advantage to me:
one being in oculoplastics, where a lot of
pathology is in air and secondly my wife being a
pathologist, made me rehearse all important and
real slides in the comfort of my
house!!!)

Will you believe
what slides I got:

1) Retinoblastoma

2) Thyroid
myopathy

3) Squamous cell
carcinoma.

I came back to my
house after this and did not go to see the
results personally, as I was worried by
neurophthalmology and ophthalmic surgery that I
neither performed to my satisfaction nor to the
examiners! Lots of comments by my friends that I
should not write with only a month’s prepration
came to my mind. Told myself that ‘I should have
listened to them’. ‘Wasted my Dad’s money!’ ‘I
will never write these exams again’! so on and
so forth!

When my friend
revealed the results and that I was allowed to
go forward, a relief dawned and immediately the
batteries were recharged and geared up for one
last time-CLINICALS.

DAY 3:

CLINICALS: Always
read WONG thoroughly along with Dr Ayman’s
presentations on FRCS groups. Practice all the
common clinical techniques fluently as the state
of mind won’t be such that we can think and do
them on spot! Most of us have a habit of doing
I/O’s with the patient supine. Practice with
patients sitting upright as that is what you
need to do there! Keep all instruments in
working conditions many days in advance! Keep
spare batteries for your torches and scopes! Try
to be quick in examining! The more the number of
cases you do, the better it is!

CASE 1:

90D of a 10 year
old boy! There was an irregular, mild grayish
scar with pigmented borders in the macular area!
Asked about DD and discussion of toxoplasmosis
briefly.

CASE 2:

20D of a patient
with resolving Vit H’ge, PDR, isolated fibrous
bands and fresh laser marks. Discussion went
into CSME, macular grid, further management of
the patient!

CASE 3:

A teenage girl
with exotropia! I did not do this case well as
usual because squint is my graveyard! The case
actually had a trauma with a stick 5years back
and there was a corneal scar as well! The
examiner was asking many things, that I know
could have been simple to answer but my brain
stops ticking when Squint arrives specially in
exam situations! Both the examiners were not
pleased and neither I with myself and I was
feeling I am going to let down my well wishers!
My ordeal was not going to end here as my next
assignment was same graveyard:Squint’ God save
me!

CASE 4:

Was asked to
examine ocular motility. Did the technique well
but again the questions were going above my
head! The examiners did not persist with this,
thank god!(God was on his way to my rescue!)
They were O.K with what I did, the technique.

CASE 5:

A case with marked
enophthalmos! (God finally brought oculoplasty
for me!) Discussion went into blow out# , was
asked to see with direct ophthalmoscope, started
right away on the job (when the examiner
switched off the lights by himself, realized my
mistake that I should have asked for the lights
to be dimmed off. Corrected myself immediately
by saying the examiner thankyou for switching
off the light! Thankgod , he did not switch off
my pass light for this!) The fundus showed
traumatic optic neuropathy. The examiner
appeared pleased that I quickly handled this
case. The time was running out when a final case
was given.

CASE 6:

Guess what I got!
OSSN. Described quickly all the findings and how
I would manage this and post excision cryo
techniques and post surgical mitomycin and
followup! The examiner appeared pleased.

RESULTS:

Clinical session
was over in the morning and had to wait till
evening! Was tense but chalked out plans for
both the eventualities of the result! What
lonely spots I would visit if I fail and how I
would celebrate if I pass! How I would convince
my loved ones and friends if I fail! ( I would
tell them see with first attempt and less
preprations, at least I have reached till final
stage and so have at least some face,though
atrophic to show you all!)

The results were
favourable! I rejoiced! Thanked God, all my
teachers with a special thanks to Dr
Subrahmanyam, who brought me into plastics, Dr
Santosh Honavar (Who is an infinite inspiration
for me!) for the moral support throughout and
believing in me that I would pass. Dr Ramesh
Murthy for always being there for me! Dr
Ramesha.K , whose great smile soothes during the
exam time!

If anybody needs
my help (although I passed by luck) kindly do
not hesitate to contact me at
drjaved007@gmail.com .